Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial
Objectives: To assess the effect of a pharmacist telephone counselling intervention on patients’ medication adherence.Design: Pragmatic cluster randomized controlled trial. Setting: 53 Community pharmacies in The Netherlands.Participants: Patients ≥18 years initiating treatment with antidepressants,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-08-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00269/full |
| _version_ | 1828351758767751168 |
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| author | Marcel Jan Kooij Eibert R Heerdink Liset Van Dijk Erica C.G. Van Geffen Svetlana V. Belitser Marcel Louis Bouvy |
| author_facet | Marcel Jan Kooij Eibert R Heerdink Liset Van Dijk Erica C.G. Van Geffen Svetlana V. Belitser Marcel Louis Bouvy |
| author_sort | Marcel Jan Kooij |
| collection | DOAJ |
| description | Objectives: To assess the effect of a pharmacist telephone counselling intervention on patients’ medication adherence.Design: Pragmatic cluster randomized controlled trial. Setting: 53 Community pharmacies in The Netherlands.Participants: Patients ≥18 years initiating treatment with antidepressants, bisphosphonates, Renin-Angiotensin System (RAS)-inhibitors or statins (lipid lowering drugs). Pharmacies in arm A provided the intervention for antidepressants and bisphosphonates and usual care for RAS-inhibitors and statins. Pharmacies in arm B provided the intervention for RAS-inhibitors and statins and usual care for antidepressants and bisphosphonates.Intervention: Intervention consisted of a telephone counselling intervention 7-21 days after the start of therapy. Counselling included assessment of practical and perceptual barriers and provision of information and motivation. Main outcome measure: Primary outcome was refill adherence measured over 1 year expressed as continuous outcome and dichotomous (refill rate≥80%). Secondary outcome was discontinuation within one year.Results: In the control arms 3,627 patients were eligible and in the intervention arms 3,094 patients. Of the latter, 1,054 patients (34%) received the intervention. Intention to treat analysis showed no difference in adherence rates between the intervention and the usual care arm (74.7%, SD 37.5 resp. 74.5%, 37.9. More patients starting with RAS-inhibitors had a refill ratio ≥80% in the intervention arm compared to usual care (81.4% versus 74.9% with odds ratio (OR) 1.43, 95%CI 1.11-1.99). Comparing patients with counselling to patients with usual care (per protocol analysis),adherence was statistically significant higher for patients starting with RAS-inhibitors, statins and bisphosphonates. Patients initiating antidepressants did not benefit from the intervention.Conclusions: Telephone counselling at start of therapy improved adherence in patients initiating RAS-inhibitors. The per protocol analysis indicated an improvement for lipid lowering drugs and bisphosphonates. No effect for on adherence in patients initiating antidepressants was found. |
| first_indexed | 2024-04-14T01:43:55Z |
| format | Article |
| id | doaj.art-48a2306ca19b4feb852937bf433c4553 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-14T01:43:55Z |
| publishDate | 2016-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-48a2306ca19b4feb852937bf433c45532022-12-22T02:19:37ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122016-08-01710.3389/fphar.2016.00269215605Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trialMarcel Jan Kooij0Eibert R Heerdink1Liset Van Dijk2Erica C.G. Van Geffen3Svetlana V. Belitser4Marcel Louis Bouvy5Utrecht UniversityUtrecht UniversityNIVELNierstichtingUtrecht UniversityUtrecht UniversityObjectives: To assess the effect of a pharmacist telephone counselling intervention on patients’ medication adherence.Design: Pragmatic cluster randomized controlled trial. Setting: 53 Community pharmacies in The Netherlands.Participants: Patients ≥18 years initiating treatment with antidepressants, bisphosphonates, Renin-Angiotensin System (RAS)-inhibitors or statins (lipid lowering drugs). Pharmacies in arm A provided the intervention for antidepressants and bisphosphonates and usual care for RAS-inhibitors and statins. Pharmacies in arm B provided the intervention for RAS-inhibitors and statins and usual care for antidepressants and bisphosphonates.Intervention: Intervention consisted of a telephone counselling intervention 7-21 days after the start of therapy. Counselling included assessment of practical and perceptual barriers and provision of information and motivation. Main outcome measure: Primary outcome was refill adherence measured over 1 year expressed as continuous outcome and dichotomous (refill rate≥80%). Secondary outcome was discontinuation within one year.Results: In the control arms 3,627 patients were eligible and in the intervention arms 3,094 patients. Of the latter, 1,054 patients (34%) received the intervention. Intention to treat analysis showed no difference in adherence rates between the intervention and the usual care arm (74.7%, SD 37.5 resp. 74.5%, 37.9. More patients starting with RAS-inhibitors had a refill ratio ≥80% in the intervention arm compared to usual care (81.4% versus 74.9% with odds ratio (OR) 1.43, 95%CI 1.11-1.99). Comparing patients with counselling to patients with usual care (per protocol analysis),adherence was statistically significant higher for patients starting with RAS-inhibitors, statins and bisphosphonates. Patients initiating antidepressants did not benefit from the intervention.Conclusions: Telephone counselling at start of therapy improved adherence in patients initiating RAS-inhibitors. The per protocol analysis indicated an improvement for lipid lowering drugs and bisphosphonates. No effect for on adherence in patients initiating antidepressants was found.http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00269/fullMedication AdherenceantidepressantinterventioncounsellingpharmacistBisphosphonate |
| spellingShingle | Marcel Jan Kooij Eibert R Heerdink Liset Van Dijk Erica C.G. Van Geffen Svetlana V. Belitser Marcel Louis Bouvy Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial Frontiers in Pharmacology Medication Adherence antidepressant intervention counselling pharmacist Bisphosphonate |
| title | Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial |
| title_full | Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial |
| title_fullStr | Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial |
| title_full_unstemmed | Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial |
| title_short | Effects of Telephone Counselling Intervention by Pharmacists (TelCIP) on medication adherence; results of a cluster randomized trial |
| title_sort | effects of telephone counselling intervention by pharmacists telcip on medication adherence results of a cluster randomized trial |
| topic | Medication Adherence antidepressant intervention counselling pharmacist Bisphosphonate |
| url | http://journal.frontiersin.org/Journal/10.3389/fphar.2016.00269/full |
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